The incidence and risk factors of atrial high‐rate episodes in patients with a dual‐chamber pacemaker

Abstract

Abstract Background and Objectives Cardiovascular implantable electronic devices can detect atrial high‐rate episodes (AHREs). However, the predictors of clinically relevant AHREs have not been well identified. Methods This prospective study included 145 patients (median age 64.5 ± 16.4 years, 53.1% females) without atrial fibrillation (AF) from December 2020 to January 2022. AHREs were defined as a programmed atrial detection rate >190 beats per minute. Cox regression analysis was used to identify the risk factors of AHREs. Results During 6 months of follow‐up, AHREs occurred in 30.3% of patients. Multivariable Cox regression analysis showed factors related to development of AHREs including using anti‐arrhythmic drugs (AAD) before implantation (Hazard ratio (HR) 7.71; 95% confidence interval [95% CI], 2.58–23.02, p < .001), history of paroxysmal supraventricular tachycardia (PSVT; HR 2.45; [95% CI], 1.18–5.09, p = .016), the percentage of premature atrial contraction (PAC) on 24‐h Holter electrocardiogram (ECG) monitoring (HR 1.008; [95% CI], 1.003–1.014, p = .003), and left ventricular global longitudinal strain (GLS‐LV; HR 0.92;[95% CI], 0.84–0.99, p = .049). Conclusions This study showed that a history of PSVT and using AAD, the percentage of PAC on 24‐h Holter ECG monitoring, and GLS‐LV were the independent predictors of new‐onset AHREs.

Keywords

• atrial high‐rate episodes (AHRE)
• global longitudinal strain (GLS)
• subclinical atrial fibrillation